Infertility

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    Intrauterine insemination (IUI) is performed at different stages in a woman's cycle, depending on whether or not her ovulation is being stimulated with medications.

    • Without Stimulation. If no female factors are causing infertility, IUI may be performed during a natural ovulation cycle with no medications. The timing of IUI is determined by using an “ovulation predictor” urine test, with the procedure performed the day after a positive test. Ultrasound exams may be used to help determine exact timing.
    • With Stimulation. To improve the chances of ovulation and to increase the number of eggs that are released, some women take medication such as clomiphene citrate (Clomid, Serophene) or letrozole (Femara). These medications are usually taken daily during cycle days five through nine, followed by IUI timed with urine luteinizing hormone (LH) kits.
    The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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    Generally, your partner will come to the fertility office the morning of your treatment to provide a semen specimen, which will be processed in an andrology laboratory. After a semen specimen is produced by the husband or partner, the sperm are counted and processed. The processing is done to remove the seminal fluid. In some circumstances, your partner may collect a sample at home, provided it is delivered in a sterile container to the laboratory within 30 minutes of collection. The clinic will provide a kit for this purpose.

    The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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    A , Reproductive Endocrinology, answered
    Performing intrauterine insemination may result in an increase in the number of sperm at the site of fertilization in the fallopian tube. Generally only 1 of 2000 sperm ejaculated into the vagina can later be found in the fallopian tube. Therefore, adding insemination to stimulated cycles may further improve the pregnancy rate. A possible side effect of the injectable fertility drugs is ovarian hyperstimulation, a condition in which the ovaries are tender and enlarged. In severe cases, a woman may have swelling from retaining excessive amounts of body fluid in the tissues. Fortunately, severe hyperstimulation is rare, occurring in less than one percent of treatment cycles.
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    If the intrauterine insemination (IUI) is successful, conception normally occurs approximately 24 hours after ovulation, and the embryo will implant between cycle day 20 to 24. If you do not experience a period by day 14 from your time of ovulation or IUI, you should take a home pregnancy test. If it is positive or if your cycle doesn’t start, visit the clinic for a serum blood test to check for pregnancy.
    The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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    A physician performs the intrauterine insemination (IUI) approximately one hour after the semen arrives in the laboratory for processing. After a speculum is inserted into the vagina, a narrow catheter is slipped through the cervical canal. Sperm are deposited in the upper portion of the uterus. No medication or anesthetics are required, and the procedure is usually painless. Once the catheter and speculum are removed, you will remain lying down with your hips slightly elevated for 15 minutes.
    The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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    A answered
    Artificial insemination may be recommended if you are a man who wants to conceive a child but who:
    •  has a low sperm count
    •  has sperm with poor motility (the ability to move spontaneously and powerfully to reach the egg)
    •  is unable to achieve an erection
    •  has retrograde ejaculation (a condition in which sperm are ejaculated into the bladder instead of out the penis)
    Artificial insemination may also be recommended if you are a woman who is part of a couple that wants to conceive a child, and you:
    •  have a scarred or damaged cervix
    •  have problems with your cervical mucus
    •  have been diagnosed with unexplained infertility
    Artificial insemination is the placement of sperm directly into a woman's uterus by using a syringe with a catheter. It is usually performed within 24 to 36 hours of a woman ovulating. Before insemination, the sperm is washed or "separated," a process that concentrates the healthiest, most motile sperm to increase the odds of successfully fertilizing the egg.
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    A answered
    Artificial insemination is the placement of sperm directly into a woman's uterus by using a syringe with a soft or firm catheter. Also called intrauterine insemination or IUI, artificial insemination may be recommended for infertile couples who have male factor infertility, unexplained infertility or problems with the woman's cervical mucus. It may also be used with donor sperm for single women or couples in which using the man's sperm is not possible.

    Artificial insemination is usually performed within 24 to 36 hours of ovulation (the release of the egg from the ovary into the fallopian tube), as predicted by using an at-home ovulation kit, by an ultrasound or by using fertility awareness methods. Before insemination, the sperm is usually washed or "separated," a process that concentrates the healthiest, most motile sperm to increase the odds of successfully fertilizing the egg.
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    After the intrauterine insemination (IUI) procedure, you may leave the office and go about your usual activities. Light spotting after the procedure, as well as leakage of some insemination fluid, may occur; this discharge is normal. If you experience light cramping, you may treat it with acetaminophen. Do not take nonsteroidals, such as ibuprofen or naprosyn, as these medications may affect ovulation.
    The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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    A answered
    Fertility awareness is a method a woman can use to determine when she is most likely to ovulate, and is therefore most likely to become pregnant. She can then use this method either to prevent pregnancy by avoiding sexual intercourse during her most fertile days, or to increase her odds of becoming pregnant by making sure to have sexual intercourse during those fertile days.
     
    There are several methods for determining your most fertile time of month.
    • The Temperature Method. A woman's body temperature rises slightly each month right at the time of ovulation. By taking her temperature every day first thing in the morning, she can detect this rise and know about the time her ovary is releasing an egg.
    • Cervical Mucus Method. Around the time of ovulation, a woman's cervical mucus increases and also becomes clear and slippery, the consistency of a raw egg white, making it easier for sperm to swim through to reach and fertilize an egg. By monitoring the changes in her cervical mucus, she can identify this fertile time.
    • The Calendar Method and/or "standard days" method both involve keeping track of menstrual cycles on a calendar and identifying how long they are, then determining which days are fertile days and avoiding intercourse during those days.
    If used correctly for pregnancy prevention, fertility awareness methods can be as much as 95 to 97 percent effective. However, about 25 percent of women who don't use fertility awareness methods correctly all the time will become pregnant. Women who have irregular menstrual cycles may be at particularly high risk of unplanned pregnancy while using fertility awareness methods. Also, fertility awareness methods do not protect against sexually transmitted diseases.
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    A , Reproductive Endocrinology, answered
    For women who are unsure of when they ovulate, keeping a basal body temperature chart for several months may help identify the time of ovulation. Charting involves taking one's temperature every morning upon waking up and recording the results. For optimal accuracy, this must be performed before the woman drinks a cup of hot coffee or brushes her teeth, as these events can interfere with the temperature reading. When the temperature goes up 0.5 degrees, the woman is in the process of ovulating. This is not recommended as a method to plan intercourse, as the rise in temperature is caused by an increase in progesterone after the follicle's release of the egg, and the window of opportunity for conception may be missed by the time the temperature rises.  Though it is a reasonable first step to attempting conception, if the results are inconclusive after three months, it is recommended that the couple move on to other methods to detect ovulation, such as the urinary LH detection kits.
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